D.C.'s Vincent Orange calls for vote on mandated nurse ratios

In a bid to revive a D.C.-mandated nursing ratio bill floundering in committee, Councilman Vincent Orange introduced an emergency measure at Tuesday's D.C. Council meeting just to push for the chance to vote on the subject.

While Orange immediately withdrew the measure, he said he believes there is a crisis in D.C. hospitals, several of which received penalties from the federal government late last year for not meeting certain quality standards, including patient satisfaction scores.

“We need to solve this once and for all,” said Orange, D-At large, a D.C. mayoral candidate.

Named the Patient Protection Act, the original legislation would penalize hospitals $25,000 a day if they fail to keep a set number of nurses per patients at all times in each major unit. The bill would also prohibit required overtime and ban counting staffing ratios based on averages. The legislation is based on a similar law passed in California about a decade ago.

The D.C. Hospital Association has opposed the bill, calling the mandate "overly simplistic" and saying it would prohibitively raise labor costs at a time when political and market forces are demanding less spending on health care.

“When you have rigid ratios, it takes away decision-making from nurse managers who are making staffing decisions based on the needs of the patients,” said Justin Palmer, director of government relations for the D.C. Hospital Association.

But Judy Alba, a local recovery room nurse and member of the National Nurses United, a national union that has partnered with a D.C. nurses union in pushing for mandated nurse ratios, said nurses' hands are tied when it comes to ensuring adequate staffing. She was among a few dozen nurse supporters who showed up to the D.C. Council meeting to rally for the bill.

“Corporate decides how many nurses we can have. We’ve been told by our direct supervisors this is what corporate says,” Alba said.

Minimum nurse ratios are a crucial standard for patient safety and the prevention of nurse burnout, she said. Those ultimately cost hospitals more, the NNU contends.

Palmer said each hospital has specific safety guidelines they follow regarding nurse staffing, but would not comment on how staffing decisions play out at individual hospitals.